26.10.16
New NHS data reveals extent of weekend patient mortality
The first NHS Digital report into seven-day service provision across the NHS has found worse outcomes for patients who are admitted at the weekend, with over 50% of trusts having significantly higher odds of mortality.
The ‘Seven-Day Services’ statistics, based on experimental data, found that the national odds ratio of mortality within 30 days of admission on Saturday or Sunday compared to Tuesday to Thursday is 1.15, “suggesting an increased likelihood of mortality”.
Of the 137 trusts included in the indicator, 58% of trusts had a significantly higher odds ratio of mortality at the weekend, and 16% had a higher mortality rate on the ‘transition period’ of Mondays and Fridays.
NHS Digital said this suggests “an increased likelihood of mortality for patients admitted at the weekend”. The research was commissioned after health secretary Jeremy Hunt made his commitment to a ‘seven-day NHS’.
The proposals have proven fiercely controversial, leading to a prolonged dispute with junior doctors over a new contract. However, the BMA recently suspended a programme of five-day strikes and invited Hunt to a symposium on improving patient care throughout the week.
A separate study from the University of Manchester’s Centre for Health Economics suggested that the belief that death rates are higher at the weekend may instead reflect the fact that fewer patients are admitted.
Leaked DH papers revealed that the department is concerned about a range of risks to the seven-day service plans, including ‘workforce overload’, the impact of the UK’s exit from the European Union, and ‘scope creep’.
The new NHS Digital data revealed that the ratios for an emergency readmission within seven days of being admitted were 1.09, 1.27 and 1.4 on Friday, Saturday and Sunday compared to Wednesday. In contrast, it was 1 for Monday, 0.99 for Tuesday and 1.03 for Thursday.
Overall, 37% of trusts had a significantly higher readmission ratios following admission on Fridays compared to Tuesdays, rising to 79% on Saturdays and 85% on Sundays.
When looking at length of stay, 52% of patients admitted on Saturday stayed for more than one day, compared to 47% of patients admitted on Thursday.
NHS Digital noted that the data was experimental and intended to be a “starting point for discussions”. It said there could be “many possible explanations”, including differences in the case mix of patients, patient behaviour and services outside the hospital such as social care.
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